Asymmetrical Information

It is the patriotic duty of every ex-smoker to overeat so that Medicare and Social Security can be saved.

I think that these “experts” are way too pessimistic. They are not planning for any new medical discoveries. It is reasonable to expect that a cure for almost every chronic disease will be found in the next 10-20 years. These discoveries will greatly reduce our Medicare expenditures.

For instance: if a cure for Alzheimer’s could be found, total Medicare costs would drop by 30-40%.

Fat people incur medical expenses for many years before dying. Their lives are expensive to the overall medical system. However, healthier people live longer, but don't incur huge expenses while they are living. Think about it..someone who is healthy with no chronic conditions might go to the doctor once or twice a year and not incur much more expense. Someone with diabetes has extra doctor's visits, along with various drugs that they have to use their entire lives after diagnosis. Now granted some of the obese people may die before they have a chance to develop cancer or get hit by a bus, which may ultimately save the healthcare system some money..and yes, premature death will help the social security system.

More pie?

Such a nice Scrooge-ian sentiment for the holidays ;) (if they are going to die, do it now, and decrease the surplus population!)

Unfortunately I don't think it will work that way. Obesity doesn't kill like, say, a shot to the head, in a way that will eliminate both medical costs and social security payments. It only increases the risk that coronary problems or diabetes will develop. Even these aliments probably won't kill like a shot to the head either, unless this person has a massive coronary while stuffing their face at the buffet. More than likely they will go through a series of increasingly serious and expensive hospitalizations before their kids take them off life support. So now we have the worst of both, people with high medical costs receiving social security checks for an extended period due to advanced medical care.

"It is reasonable to expect that a cure for almost every chronic disease will be found in the next 10-20 years. These discoveries will greatly reduce our Medicare expenditures."

Wrong. Those new treatments will in general be very expensive. For example, a cure for Alzheimer's should cut nursing home costs, but it will at best be a bunch of pills to take every day for the rest of your life, and it's possible the pills will cost more than the nursing homes. Also, they will probably keep the Alzheimer patient alive longer, not only requiring the pills for longer but increasing the chance of requiring treatment for some other very expensive condition. And Alzheimers is the best-case scenario - new treatments for most other conditions will definitely cost more than the existing treatments...

Medicare costs are going up until we develop some sort of limits on how much tax money can get spent on one person.

"Medicare costs are going up until we develop some sort of limits on how much tax money can get spent on one person"

Sad but true, especially said because "until we develop limits..." is more consisely stated as "never" because the majority of the population is elderly, and they wouldn't even accept means-testing on the last perscription drug bill, and they have the lobbying power to make their wishes law, fiscal responsiblity and good of the country be damned.

Markm, I think you're too pessimistic. We're at a stage now where companies develop drugs that delay and ameliorate various diseases. But as our understanding of the immune system grows, I expect we'll see many more simple cures.

Not all cures will save money, to be sure. Our improved understanding of heart disease, for example, changed "he had a heart attack and died" and "he has a weak heart and can't play tennis anymore" to "maybe I need another angioplasty". But at the other extreme, we don't spend much on polio these days, do we?

1. As Boomers age, their rate of annual visits to doctors, hospitals, and ERs continues to exceed the rate of previous generations;
2. We already do means-test Medicare, it's called Medicaid--although at least low-income, welfare families that never worked receive prescription benefits through their Medicaid HMO, whereas Medicare recipients who worked all their lives and depend on Social Security do not;
3. The rising cost of pharmaceuticals drives the 10-times-higher-than-the-CPI rising cost of health care more than any other economic, demographic, or health-related factor;
4. The middle-class pays the freight for welfare health care for the poor and for the old, the rich stop contributing once they earn more than $87,000, and 75% of the uninsured work full-time jobs.

1. As Boomers age, their rate of annual visits to doctors, hospitals, and ERs continues to exceed the rate of previous generations;
2. We already do means-test Medicare, it's called Medicaid--although at least low-income, welfare families that never worked receive prescription benefits through their Medicaid HMO, whereas Medicare recipients who worked all their lives and depend on Social Security do not;
3. The rising cost of pharmaceuticals drives the 10-times-higher-than-the-CPI rising cost of health care more than any other economic, demographic, or health-related factor;
4. The middle-class pays the freight for welfare health care for the poor and for the old, the rich stop contributing once they earn more than $87,000, and 75% of the uninsured work full-time jobs.

No Jake, it isn't reasonable to "expect that a cure for almost every chronic disease will be found in the next 10-20 years." Many of us can recall when a big government initiative was expected to have cancer beat Real Soon Now. That was back in the 70's. Throughout my entire life science and technology publications have been brimming with Real Soon Now predictions. All too often no product ever appeared because they could never bridge the gap between an interesting laboratory effect and real world usefulness or they were barking up the wrong tree all along ala cold fusion.

Sure, we have very promising new avenues of research thanks to things like the genome map and proteomics but none of these items come with a definitive date stamped on the side for when applicable results will be delivered. (Just add funding!) And, as pointed out above, to date we've seen damned few cures for anything. A whole hell of a lot of treatments that have given extended life and functionality to a lot of people but those tend to be expensive and do so on a continuing basis.

I think bureacracy and wretched inefficiencies from government involvement make for a a huge proportion of current health care costs but our ability to offer a widening range of life support options at considerable expense is only going to increase. Any genuine cures for major chronic illnesses like diabetes are going to have to happen in a big and relatively inexpensive way to make a dent in the bills we face in the future.

There are some bright spots. Diagnostics are currently going through great technological imporvements that promise to reduce many of those expenses by orders of magnitude. Unfortunately those are usually one time costs that are minor compared to the ongoing treatment for the condition revealed by the test.

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